Flu shot

Every fall, the refrain begins: “Time to get your flu shot!” It’s true that the annual flu vaccine is the best way to reduce your risk of getting the flu. It also lowers your risk of ending up in the hospital if you do catch the flu despite vaccination.

But not everyone should get an annual flu shot. Some people need to focus even more on preventative measures, such as frequent hand-washing and staying clear of sick people.

Here’s how to know if you have a medical reason to skip the flu shot:

Had a Severe Allergic Reaction to the Shot in the Past? Skip It.

Have you ever had a severe allergic reaction to a flu vaccine? This means a reaction with life-threatening symptoms such as difficulty breathing or sudden swelling of the lips, tongue, or throat. It might also involve severe vomiting or diarrhea. If so, you should skip the flu vaccine. Severe anaphylactic reactions are extremely rare, but they do happen.

According to a study in 2016, about 1.4 anaphylactic reactions occurred for every 1 million flu vaccine doses given. Most of the reactions occurred within four hours of getting the vaccine, and only one occurred the day after the shot. Out of 33 reactions from more than 25 million doses, only one person was hospitalized and no one died.

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What if I Have an Egg Allergy?

Most — but not all — flu vaccines are made with viruses grown in eggs. But people with a severe egg allergy should be able to get any flu vaccine, according to the Centers for Disease Control and Prevention (CDC). If you ever had a severe allergic reaction to egg — anything beyond just hives — get a flu shot at your doctor’s office. If you do have a reaction, there are health care professionals present who can recognize and manage a severe anaphylactic reaction.

There are two flu vaccines made without eggs. The Flucelvax Quadrivalent vaccine is licensed for use in people at least 4 years old. The Flublok Quadrivalent vaccine is licensed for use in people at least 18 years old. If you have questions about egg allergy and flu vaccines, visit the CDC’s page on this topic.

Any Other Allergies to Worry About?

Most people with allergies can and should get the flu shot. If you have any severe, life-threatening allergies, the CDC recommends that you ask your provider whether it’s OK to get the vaccine.

Tell Your Doctor if You’ve Had Guillain-Barré Syndrome.

Guillain-Barré Syndrome (GBS) is a neurological disorder that happens when your immune system attacks the nerves outside of your brain and spinal cord. It can cause mild to severe muscle weakness, pain, numbness, and paralysis and loss of reflexes. Roughly one out of 100,000 people develop GBS each year; most eventually recover.

It’s not clear what causes GBS, but it often follows a bacterial infection or a bout of influenza. It is rare to develop GBS after getting a flu vaccination, according to the CDC. There is a higher risk of contracting GBS after having the flu.

If you have a history of GBS, talk to your doctor before getting the flu vaccine. Some people who have had GBS may be advised to skip the shot.

Should Babies Get the Vaccine?

The CDC recommends that everyone 6 months of age and older get the seasonal flu vaccine every year. For a pregnant woman, the inactivated flu vaccine (not the live nasal vaccine) protects the mother from flu infections and complications and protects her baby for up to one year after birth. Babies whose mothers get a flu shot during pregnancy are 70% less likely to develop the flu than babies whose mothers skip the shot.

What About Everyone Else?

Get your flu shot! The flu vaccine is extremely safe for the vast majority of people. If you’ve had a severe allergic reaction to a flu shot, have an allergy to eggs, or have had GBS, tell your doctor. “If you have questions or concerns about getting a flu shot, talk to your doctor. He or she will be able to help,” says Shane Eikenberry, MD, an internal medicine specialist at Greater Pittsburgh Medical Associates-UPMC.

Sources

Cell-Based Flu Vaccines. Centers for Disease Control and Prevention. Link.

Flu Vaccine and People with Egg Allergies. Centers for Disease Control and Prevention. Link.

Guillain-Barré syndrome and Flu Vaccine. Centers for Disease Control and Prevention. Link.

Guillain-Barré Syndrome Fact Sheet, National Institute of Neurological Disorders and Stroke. Centers for Disease Control and Prevention. Link.

Guillain-Barré Syndrome, Vaccine Safety. Centers for Disease Control and Prevention.Link.

Inactivated Influenza VIS, Vaccine Information Statements. Centers for Disease Control and Prevention. Link.

Julie H. Shakib et al. Influenza in Infants Born to Women Vaccinated During Pregnancy. Pediatrics. May 2016. Link.

Kwong JC et al. Risk of Guillain-Barré syndrome after seasonal influenza vaccination and influenza health-care encounters: a self-controlled study. Lancet Infectious Disease. Sept. 2013. Link.

Lehmann HC et al. Guillain-Barré syndrome after exposure to influenza virus. Lancet Infectious Disease. Sept. 2010. Link.

Michael M McNeil et al. Risk of Anaphylaxis After Vaccination in Children and Adults. The Journal of Allergy and Clinical Immunology. March 2016. Link

Recombinant Influenza (Flu) Vaccine. Centers for Disease Control and Prevention. Link.

Who Should and Who Should Not Get Vaccinated, Influenza. Centers for Disease Control and Prevention. Link.

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